Archive for the ‘go blue florida’ Category

Florida’s health insurance exchange will open for business on October 1 of this year, with plans taking effect next January 1. The health insurance exchanges will offer more coverage options to Americans who couldn’t afford health insurance before. That is the idea at least. Florida Blue’s Joe Gregor does believe that consumers will have more affordable options and less difficulty finding health insurance when the Affordable Care Act takes full effect. According to the Orlando Sentinel’s “More details emerge on Florida health insurance exchange,” Marni Jameson said that we now know how many insurers will offer plans in each Florida county. It’s actually not as many as you might expect, with some counties only having one insurer offering plans. Blue Cross Blue Shield will be the lone insurer in some of the more rural counties, but they assure Floridians that their prices reflect expected competition and not the fact that they are the sole option in some places.

Ten insurance companies were federally approved to offer plans in Florida, some in one county and some in many of Florida’s 67 counties. Aetna Life Insurance Company, Blue Cross Blue Shield of Florida, Cigna Health & Life Insurance Company, Coventry Health Care of Florida Inc., Florida Health Care Plan Inc., Health First Health Plans, Health First Insurance Company, Health Options Inc., Humana Medical Plan Inc., and Molina Health Care of Florida Inc. are the ten approved companies. Blue Cross Blue Shield of Florida will be the only insurance company offering affordable coverage in all 67 counties. The big counties in South Florida like Miami-Dade and Broward will have nine different choices, but which insurers are operating in which counties has yet to be released. Palm Beach county residents will have eight insurance choices and most Central Florida counties have five or six different options from which to choose.

Each insurance company will offer different tiers of plans that will range from bronze to platinum. The lower plans will obviously offer less coverage than the highest plans, but you can choose what you need for the price you will be able to afford. The government is offering credits to Americans with certain income levels to help pay for the cost of their mandated health insurance. In order to receive any government help with health insurance though, you have to choose from the federally approved plans. In 21 counties in Florida, Blue Cross Blue Shield or Florida Blue as they operate in the state, will be the only insurance exchange option. Other counties will have more choices. But each county will have at least one insurance company operating in it, something that some state have not yet been able to accomplish. If you live in Florida and are looking to purchase health insurance through the new exchange soon, you should have some affordable options for coverage.

Changes to health insurance plans have already started and the bulk of changes are still looming in the near future. With rising costs and unhappy Americans, some employers are taking creative approaches to dealing with increasing health plan costs. In “Your health plan: the next frontier,” Money’s Amanda Gengler tells us what we can likely expect with the future of health insurance plans. One small company owner in Missouri made big changes when he saw skyrocketing health care costs and an increasing number of sick days being used. He made healthy changes to the vending machines, opened a fitness center, gave free on-site check-ups, and gave big financial incentives in the form of lower deductibles and no premiums for workers who took steps to be healthy. A big portion of increasing health care costs has been passed onto employees through higher deductibles, premiums, and co-pays. But making healthier choices to avoid needing so much medical care is a newer way to try and save money. It certainly benefits employees in more ways than one.

Prices vary widely from doctor to doctor, especially if you choose one that is out of network. New plans will likely streamline your choice of doctors even more and staying in that smaller group could save you big on your premiums. Insurers and employers save money if you don’t visit top shelf doctors who order more tests than average. Estimates show that around 1/3 of big companies will have this type of streamlined plan by next year. This plan might even force you to pay the entire cost of seeing an out of network doctor. If this type of plan becomes an option to you, research what doctors and hospitals you will lose out on and see if you are happy with the replacements available. Florida Blue says that local big-names and academic med centers aren’t usually included in these streamlined plans though.

Many companies will have you choosing your own health plan from a list they have chosen in the future. They may pay a percentage of your plan costs or a fixed dollar amount, and the plans may even be in the private exchanges. Plan to spend a lot more time researching plans and options and maybe even switching to a high-deductible plan to save money. Since you will be paying a bigger percentage of your bills, employers are hoping that you will make more cost-efficient health decisions and stay healthier overall. A healthier America may just be what it takes to lessen the increase or even decrease health care costs overall. Expect a lot more health initiatives from your employer that could lower parts of your plan costs or offer you rewards, even cash. But on the flip side, you might get charged more for a high BMI or high cholesterol, especially if you aren’t doing anything to change it. The Money article has some great examples and personal stories of how health plans have changed and will continue along that road in the future.

Blue Cross and Blue Shield of Florida Inc. now has a new name, according to the Jacksonville Daily Record’s “BCBS is now Florida Blue.” The company is changing their focus from simply being a health insurance company to more of a health solutions company, and they hope that the name Florida Blue will help with that transition. They will remain a non-profit company owned by its policyholders and paying taxes as a mutual company. Along with the new moniker Florida Blue, the company will have a new logo and use the tagline “In the pursuit of health.” Both old customers and new consumers will begin seeing signage, ads, and even sponsorships almost immediately.

They are changing their business model from a focus solely on health insurance to one that is more multi-dimensional. Many health insurance companies are realizing that a more comprehensive view on healthcare is a great way to eventually lower costs and make consumers healthier by focusing on healthy habits before they need health care for being sick. Blue Cross Blue Shield of Florida has been around for almost 70 years and is known for very personal service and a strong customer focus. Programs like the affordable Go Blue Florida are likely to remain intact, possibly with some changes to focus even more on preventative health.

It’s hard for parents to determine when they should take their sick kids into the doctor and when it is okay to ride it out at home. With the rising health insurance rates, co-pays and deductibles, you don’t want to be at the doctor weekly when they are just going to send you home and say that time will be the healer. Parents magazine’s Kristyn Kusek Lewis tells us the “12 Kids’ Symptoms You Should Never Ignore.”

Fevers are important to watch because they can signal serious internal problems, but a fever isn’t always dangerous. Based on your child’s age, know the temperature your doctor wants to see your child at, no matter what other symptoms they may have. This is typically 100.4 for infants and 103 for children up to 2 years of age. If your child has a fever that isn’t lowering with treatment, has lasted longer than 5 days, or comes along with a stiff neck, headache or dangerous rash; they should see the doctor.

Rashes that look like a bullseye or red dots that don’t disappear when you press down on the area can be dangerous and should be checked by a doctor. Also make sure to check your child’s moles for any changes from year to year. Moles they have had since birth have a greater chance of becoming cancerous. Appendicitis symptoms include lower right side abdomen pain or stomach pain that is crampy and comes in waves. Treating conditions before they worsen is crucial to the well-being of your family. It can also save you money with a health plan like Go Blue Florida, which covers more basic doctors visits.

A headache that occurs first thing in the morning, wakes a child from sleep, or comes with vomiting is likely a migraine. Signs of dehydration include dry mouth and lips, excessive vomiting or diarrhea, lessened urination, and skin that is dry or stays bunched up when pinched. Very labored breathing or irregular sounds while breathing are serious and warrant a trip to the doctor or ER. Swelling of the tongue, lips, or eyes, or extreme itchiness or vomiting indicate an allergic reaction. Any fall for an infant or a high fall with visible signs of injury or neurological changes should be treated by a doctor. Finally, any cut that is wide enough to fit a cotton swab or continues bleeding after a few minutes of applied pressure should be treated by a doctor. Parents have to go with their instincts when treating their kids, but this guide could help save some unnecessary doctor visits.

As they are fighting the federal health exchanges mandated by the government in 2014, Florida is introducing their own slightly different version now. Phil Galewitz’s Washington Post article, “Florida to launch its own health insurance marketplace,” points out that Florida’s version of the plan has significant differences from the federal mandates. The main difference is that Florida’s plan is only offered to small businesses and not to individuals. Small businesses can shop online for health insurance rates from multiple insurance companies with just one application. Florida is the third state with such a partnership between the public and private industries.

There are two more significant differences between Florida’s exchange and the federal guidelines. No subsidies or tax breaks will be offered to the small businesses to help them offer health insurance, while the government plan offers help to its individuals and small businesses. There also is not a requirement for companies to offer what the government deems ‘essential health benefits’ in Florida’s exchange. Since both insurance companies and agents have to pay to use Florida’s exchange, many argue that they don’t see any significant savings being possible. But the Florida government begs to differ and point out many benefits with their exchange. While individuals will still have to look for affordable insurance from plans like Go Blue Florida, small businesses will now get multiple rate quotes with one application and be able to offer up to four different plans to their employees.

Cuts to Medicaid are proposed in both President Obama’s debt reduction plan and a current House bill sponsored by Rep. Paul Ryan of Wisconsin. According to Jay Greene of Crain’s Detroit Business, a study by The Lewin Group and Families USA showed that 120,000 kids in Michigan with lung disease could be devastated by these cuts. In the article “Report: Medicaid cuts could seriously hurt residents in Michigan with diabetes and lung disease,” Greene says that in addition to pain, suffering, and increased death, Medicaid cuts could inevitably lead to higher costs.

The third leading cause of death in the U.S., lung disease in children is most commonly associated with asthma and cystic fibrosis. There are almost 240,000 Michigan residents on Medicaid receiving care for these lung diseases as well as chronic obsessive pulmonary disease and other lung diseases. Medicaid also covers around 100,000 people fighting diabetes, which is the nation’s seventh highest cause of death. Close to 250,000 residents receive Medicaid for heart disease and stroke, as well as around 23,000 for cancer treatment. With cuts to Medicaid trickling down to states like Michigan, they would have no choice but to deny Medicaid to some people.

Over the next decade, cuts have been proposed between $15 and $771 billion for Medicaid. These cuts could reduce state funding by 30% and force those with less serious cases to stop receiving Medicaid altogether. Residents would have to compare lower cost health insurance alternatives like Go Blue Florida, which helps residents of that state. Until it is mandatory for health insurance companies to cover those with preexisting conditions however, many of those suffering from lung disease or diabetes might be forced to go without insurance. That would be devastating to everyone involved, especially sick kids.

An interesting part of the healthcare reform act from last year will allow 3 million middle class Americans to qualify for Medicaid. This could put a huge strain on the government and seems to many lawmakers to be a mistake. The Associated Press article “AP Exclusive: Medicaid for the middle class?,” by Ricardo Alonso-Zaldivar, discusses the possible loophole. Medicaid health insurance is meant to help the poorest Americans, but will now be available to pre-retirees making around $64,000, or 138% of the federal poverty level, starting in 2014. Pre-retirees who compare health insurance might decide to take the government up on this free healthcare until they qualify for Medicare at age 66.

The loophole allowing millions more Americans to qualify for Medicaid is that Social Security will no longer be included in the income eligibility determination for the government health insurance. A spokesman from the Health and Human Services Department said that they are concerned about middle class Americans qualifying for a program meant only to help the neediest in America. The main concern is over the financing of course. Millions more getting relatively free healthcare means millions more government dollars being spent. Early retirees can get Social Security benefits as early as age 62, but are not eligible for Medicare health insurance until age 66. Currently, they have to find another form of health insurance, whether they get a limited benefit plan like Go Blue Florida, or comprehensive individual health insurance. It is likely that something will be done to change this loophole before it is to take effect in 2014, but if not this could mean big bucks paid out by the federal and state governments.

After losing the preferred clinic for porn actors in the San Fernando Valley, an industry trade association is helping to get care for the actors. Shaya Tayefe Mohajer’s article, “Porn trade group has plan for actor health care,” was published in Bloomberg Business Week. The trade group Free Speech Coalition has arranged for a network of doctors, hospitals, and facilities to get labwork and testing done after the workers compare health insurance quotes. The Adult Industry Medical Health Care Foundation, serving the L.A. area, closed recently after a number of problems including an HIV positive actor complaining about poor care.

The porn industry makes billions of dollars each year and employs a large number of actors, who need routine testing, preferably in a discreet environment. Not only did the Adult Industry Medical Health Care Foundation take care of STD tests and other medical care for a multitude of actors, it also helped producers in their casting. The Foundation maintained STD records for its patients, which producers could check before making casting decisions. Some porn actors have health insurance through trade associations or other companies, while others must shop around for low cost individual health insurance comparable to Go Blue Florida. It is possible that their riskier careers could cost them more when they compare health insurance quotes.

One of the most recent changes from the Patient Protection and Affordable Care Act of 2010 is a new ratings system for Medicare Advantage Plans, says Patty Henetz of The Salt Lake Tribune. In the article “New ratings for Medicare Advantage plans may boost quality in Utah, nation,” we learn that insurers will be judged on 36 factors related to 5 different groupings and issued a rating between one and five stars. Companies consistently rating above average will be rewarded with incentives like rebates and bonuses. This quality control rating system allows consumers to pick their insurer based on more than just health insurance rates, but the quality of service they will receive as well. The incentives to insurers also make it more lucrative for insurance companies to offer quality service to consumers.

The federal Medicare website will flag insurance plans that have had ratings below three stars for three consecutive years with a warning sign. Unfortunately for consumers in Utah and much of the central U.S., the highest rated plans are not available to them. Not one five star plan was available in Utah and noone in the state was signed up for a four star plan, probably due to low availability. If the ratings systems improve the quality of plans like the government hopes, residents of Utah and other central states should have access to better Medicare Advantage plans soon.

Out of the 523 plans rated, only three received a five star rating this year. The highest rated plans were in Florida, competing with Go Blue Florida, Wisconsin, Colorado, and Arizona. Non-profit insurance companies tend to have higher ratings than those for profit. States in the Northeast and on the West Coast seem to have higher rated plans available than other areas. Lower enrollment and plans that are too new are two reasons that those in the central U.S. had a harder time finding highly rated plans. In addition to ratings based on factors like customer service, healthy consumers, and responsiveness; increases of health insurance rates will also be closely monitored. Any increase above 10% for monthly payments will be more closely reviewed.

According to a company press release, Blue Cross and Blue Shield of Florida has received an award for their high customer satisfaction. In “Blue Cross and Blue Shield of Florida Awarded Prestigious J.D. Power and Associates Award,” we learn that the company has received this award for the third time. They have received the award for “Highest Member Satisfaction among Commercial Health Plans in Florida.” Go Blue Florida is just one of the plans Blue Cross and Blue Shield offers Florida residents. Their customer service skills reach across their entire network of plans.

The 2011 National Health Insurance Plan Study from J.D. Power and Associates polled health insurance members in 17 regions throughout the United States. They were asked to compare health insurance plans from 2010 on a number of factors regarding their overall experience. The seven main factors companies were judged upon are the approval process, processing of claims, their coverage and benefits, customer service, information availability and communication skills, provider choice, and their statements. Blue Cross and Blue Shield of Florida is pleased that the commitment to their members shows and they plan to use the survey information to improve their customer service even further.